May 08, 2014

Diminishing Industry Support for Oncology CME - May Hinder the Adoption of New Therapies

Oncology breakthroughs develop at an amazingly fast rate. Reuters recently reported that a new lung cancer study will allow researchers to test up to 14 drugs from AstraZeneca and Pfizer at the same time within one trial. How do oncologists keep up with new developments? Continuing medical education (CME) plays a vital role. In recent years, commercial funding for CME has dropped significantly, yet, little has been written about how this might affect CME in oncology, a field in which new drugs and advances emerge at a rapid pace.

In 2012, commercial support represented 27.3 percent of total CME funding, down from 46 percent of total funding in 2007. This marked thesixth year of decline. However, it is important to understand that eliminating resources from the CME system is not a no-risk alternative, as some critics argue. The Consequences of Diminishing Industry Support on the Independent Education Landscape: An Evidence-Based Analysis of the Perceived and Realistic Impact on Professional Development and Patient Care Among Oncologists, which wasrecently published in the Journal of Cancer Education, examines this issue.

The paper, authored by John Ruggiero, PhD, MPA, CCMEP; Mazi Abdolrasulnia, PhD, MBA; Caroline Robinson, PhD; and Stephen Burton, MS, and supported by Genentech, Inc., looks at the role that oncologists and oncology fellows say that CME plays in their ongoing professional development. It also polls their attitudes about the potential impact upon both the dissemination of medical information and the impact on patient care if commercial support were removed from CME.

Oncologists: Commercial Supported Oncology CME is Important

The study consisted of 283 oncologists and 85 oncology fellows. The majority of oncologists (90 percent) and oncology fellows (78 percent) "agree" or "strongly agree" that commercial support may be more necessary for oncology than for other specialties due to the rate at which cancer therapies are introduced. Likewise, approximately 86 percent of oncologists and 74 percent of oncology fellows thought commercial support is appropriate for CME activities to share clinical trial information related to a new drug or indication.

Oncologists responded that they most sought educational opportunities to better their practice performance, including access to up-to-date oncology information and state-of-the-art approaches, best practices for patient care, solutions to complex clinical problems, and advancements in evidence-based practice.

Commercial support plays an important role in providing this cutting-edge information, as shown by the study.

Three-quarters of the respondents indicated that commercial support is a significant reason high quality oncology CME is available. Furthermore, approximately 88 percent of oncologists said it is somewhat to very likely that implementation of new or emerging therapies would be slower if commercial support is reduced, and 89 percent said implementation of evidence based-medicine would be slower. Guideline development would also be prolonged according to 81 percent of oncologists.

When asked about their concerns with removing commercial support, oncologists responded that the lack of commercial support for CME would negatively impact the cost of CME, the availability of professional development opportunities, and access to CME. About half of the oncologists perceive that the loss of commercial support for CME will have a negative impact on their application of new and emerging therapies within practice due to the reduction in number and speed of dissemination of CME on new and emerging treatments.

Oncologists' Perceptions of the Impact on Oncology Knowledge Transmission Due to Removal of Commercial CME Support

Despite the clear indications that a lack of commercial support would make the timing and accessibility of CME more drawn out and burdensome, oncologists were "reluctant to claim the removal of commercial support would negatively affect the practice of evidence-based medicine, patient outcomes, or patient safety," the authors note.

While oncologists responded that patient care would not suffer without commercial support, the authors discussed that in order to stay ahead of the innovation curve in their discipline, oncologists themselves would bear the burden. They would have to pay increased costs and spend more time accessing information and digging through studies.

Today, doctors have so many administrative tasks that some report doctors'average patient time is eight minutes. Anything that further minimizes doctor-patient contact cannot be considered beneficial without strong evidence to support its value. A lack of commercial support put the onus on doctors to use their valuable time and resources to seek out information. Furthermore, in the context of oncology, it might be nearly impossible to personally stay on top of the multitude of important studies that can help patients in need.